Provider Demographics
NPI:1861677494
Name:TOWN OF HAMPDEN
Entity Type:Organization
Organization Name:TOWN OF HAMPDEN
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:B.O.H. CHAIR
Authorized Official - Prefix:MR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:R
Authorized Official - Last Name:GREEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:413-566-2152
Mailing Address - Street 1:625 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:HAMPDEN
Mailing Address - State:MA
Mailing Address - Zip Code:01036-9000
Mailing Address - Country:US
Mailing Address - Phone:413-566-2152
Mailing Address - Fax:413-566-2010
Practice Address - Street 1:625 MAIN ST
Practice Address - Street 2:
Practice Address - City:HAMPDEN
Practice Address - State:MA
Practice Address - Zip Code:01036-9000
Practice Address - Country:US
Practice Address - Phone:413-566-2152
Practice Address - Fax:413-566-2010
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-02
Last Update Date:2020-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAY11106Medicare PIN